In this newsletter article, I want to put it all together. With the past several newsletters, I have discussed the organization of the brain and the neuromuscular patterning involving stability and mobility of the human, skeletal structure. It involves the central and peripheral nervous systems and the sensory input causing the motor output that is everything we do and how we do it when talking about posture and movement. Within this organization, there is a hierarchy of sensory input with vision being numero uno making up 60% of brain neuronal activity followed by vestibular and finally proprioceptive sensory input.
The predominant sensory information that causes the reaction of your posture and movement is first that of gravity followed by the resultant ground reaction force (GRF). It is the processing and integration of this sensory input from these natural forces that the brain and nervous system create your posture and movement. It includes reflexes of the brain affecting tension of muscles on the same side of the body to create stability and reflexes of the brain affecting the tension of muscles on the opposite side of the body in volitional movements to create the mobility of the body. The human, skeletal structure is just a pile of bones without the tensile forces provided by the muscles, tendons, and connective tissue (fascia). Whereby the tension of these tissues is the product of sensory input from the external forces of gravity and GRF to create enough internal force to establish skeletal balance and equilibrium.
It is a never ending cycle of sensory input followed by motor output in creating the internal, tensile forces that becomes the position and motion of your skeletal structure. The question then has to be asked, “What structures are responsible for these tensile forces?”Answering this question simply describes life as most of us are fortunate to know and experience because, “motion is life!” First and foremost, the 650 muscles and their tendons on both sides of the body provide this output of tensile force. Each of these skeletal muscles are comprised of thousands of muscle fibers bundled together by the connective tissue system or fascia referred to as “myofascia.”
Because skeletal muscles are involved with skeletal movement, it is the common belief that they are always under our volitional control and the frontal lobe of the brain. But as I have already mentioned in previous articles, approximately only 10% of total brain output involved with posture and movement is dedicated to voluntary or volitional movement. Contrast that to 90% of brain output dedicated to creating reflexive stability of the skeletal structure through a part of the brain called the pontomedullary reticular formation (PMRF) or “old brain.”
The PMRF is responsible for creating and maintaining these postural, neuromyofascial holding patterns. It sets the tension of the muscles that creates the stability of your structure against the external forces of gravity and GRF. The volitional, movement patterns of function then occur within these holding patterns of stability. Therefore, you cannot have mobility without stability when talking about posture and movement. These neuromyofascial holding and movement patterns occur in muscle synergies where the term “syngergy” means working together.
The neuromyofascial patterns are the result of muscles coordinating stability and mobility of the skeletal structure during your functional tasks of daily living. They allow for common patterns of posture and movement in function that involve the cooperative and reciprocal activation of muscles. Because the muscles are linked in such a way, one activated muscle within a pattern may lead to partial or complete response of the other muscles within a neuromyofascial pattern. This muscle coordination in posture and movement implies how muscles work together in coordination and can be considered in terms of both the relative timing and contraction of their activity. Coordinated movement involves muscles of neuromyofascial patterns working together in synergy toward a movement goal.
The development of these neuromyofascial patterns is a dynamic process that occurs throughout life, but actually begins in utero. Within this environment of the mother’s womb, it is automatic and dependent upon the sensory orientation. These neuromyofascial patterns that develop in utero and in infants are characterized by synergy patterns that are genetically predetermined and overlap with each other. When an infant enters the world of gravity, each stage of posture and movement is the result of specific and partial neuromyofascial patterns. As the human, motor development progresses, each of these partial patterns provide the basic elements or foundation for mature, coordinated movements.
When coming into this world of gravity as infants, we have un-compromised stability and mobility and follow a progression of posture and movement patterns referred to as “neurodevelopmental milestones.” These milestones are natural, inherent and predictable with the sequence starting first with head and neck control against gravity followed by rolling, crawling, kneeling, squatting, standing, stepping, walking, climbing, and running. But even before this neurodevelopment sequence of posture and movement occurs, the act of “breathing” is foundational. As with any movement we perform in our daily lives, breathing has a gravity and GRF phase. The amount of air taken in with each breath is determined by the amount of air exhaled. Simply, the volume of inhalation is in direct response to the completeness of exhalation.
The act of breathing predominately involves the “diaphragm,” a dome-shaped muscle located just below the lungs and heart. It contracts without volitional and conscious control continuously with each breath you take in and breathe out. It is considered a skeletal muscle that sits at the base of the chest separating the chest from the abdomen. When it contracts with inhalation, it flattens creating a vacuum that pulls air into the lungs and with exhalation it relaxes pushing air out of the lungs. With an infant, its primary function is as a respiratory organ, but at about four-and-a-half moths a transformation takes place creating also a postural, holding pattern function.
The diaphragm then begins to offer the core and spinal stability of the infant’s structure to move developmentally into positions and motions other than those previously done with just external support. Czech researcher, Dr. Karl Lewit sums up how breathing is foundational to the development of our posture and movement, “respiration is our primary and most important movement pattern…and also the most dysfunctional.”
The dynamic process of what is defined as human posture and movement can be summed up as a journey in cooperation with and against gravity. The body’s inherent design allows it to distribute these external forces globally and not locally. The internal, tensile forces naturally produced by the brain and nervous system in reaction to these external forces is best understood in the terms of a particular type of geometry known as “tensegrity.”Dealing with tension, compression, and shear forces is the world of engineers as it is when talking about about human posture and movement. However ever since the days of Descartes in the 1500’s, the body has been described in the terms of a soft machine, where the bones are like girders, the muscles like cables, and the whole structure like a crane or a series of pulleys and levers understood in the terms of Newton’s laws of motion at its deepest level.
With tensegrity structures, they can hold their shape no matter what the orientation because of the internal balance of tension and compression. It is a seamless, neuromyofascial web that is impossible to completely separate, but mediates between the constant and dynamic continuum of stability and mobility of the human structure. The map of human anatomy then changes from some 650 separate muscles, to one muscle with some 650 pockets of fascia.
Within this seamless neuromyofascial web, the brain and nervous system relies upon neuromyofascial pattern recognition and prediction when it comes to creating skeletal balance and equilibrium in posture and movement. It’s organizational design is to recognize a pattern of neuronal activation so it can quickly and accurately respond to gravity and GRF keeping us upright and in harmony with these vertical forces of the earth.
To better describe these neuromyofascial patterns within this seamless web, I have used words of mathematic relationship and function such as linear, diagonal, and spiral. Coupled with the body descriptions of right/left, deep/superficial, anterior/posterior, and side I can further describe these neuromyofascial patterns. Finally, these patterns can be further defined by being pronated and supinated according to the lower extremity kinetic chain reaction to GRF. Pronated refers to the collapsing of the chain to the ground whereas supinated refers to pushing off the ground. Supination is the result of pronation and this transformation from pronation into supination is the key to human movement. Pronation and supination of the lower extremity kinetic chain occurs at all of its joints in all three planes when walking and running. For that matter, all human movement is a continuous cycle within the body whereby there is force production, stabilization, and force reduction in reaction to GRF. The force production is supination while the force reduction is pronation affecting the stability and mobility of the skeletal system. Stability being the ability to maintain and control the strength of the body and mobility being the ability to move the body through its full range of motion.
From my observations over forty years in my practice of physical therapy along with my experiences in eight years of competing for the United States Ski Team in nordic ski jumping, I have created five neuromyofascial tensile, synergy patterns by utilizing these descriptive words. They are first defined as either being right or left and supinated or pronated. The patterns are then further defined as either deep/superficial anterior anterior and posterior linear, side linear, diagonal, and spiral.
Ideally at rest in standing, the neuromyofascial tensile forces, tone provided by these patterns to create skeletal balance and equilibrium should be equal when comparing right to left allowing the body’s center of gravity (COG) to be located at its ideal location. This location is defined as the second sacral segment of the spine, equal distance between the front and back and right and left sides of the pelvic girdle. In this configuration superficially, the skeletal structure appears to be symmetrical. However, there is a natural, deeper, inherent structural asymmetry of the body from birth due to the influences of development through and around the body’s internal organs and an individual’s genetic imprint. These inherent, structural influences on the neuromyofascial web cannot be denied and are referred to as “structural holding patterns.” They are ingrained in the habits and behaviors of our posture and movement. In addition, as the maturity of the human nervous system progresses, the holding patterns of the neuromyofascial web become more influenced by functional patterns of use such as seen with hand dominance and also by compensation caused by injury and surgery creating “functional holding patterns.”
Simply put, these neuromyofascial holding patterns are shaped by both structural and functional holding patterns resulting in the body’s COG changing from the ideal. Therefore with movement, it no longer takes place from a position of ideal, but instead from an altered position. The functional holding patterns of this altered COG affects not only the integrated posture of the body, but also the alignment of its isolated joints which is now compromised. Since the “structural holding patterns”are inherent and cannot change, the focus is on the functional holding patterns that overtime can become ingrained in the tissues and joints causing compression, twisting, and even displacement. This limits the flow of all the hydrating fluids through the joint, fascia, and muscle tissue cutting off the supply of vital nutrients and hydration. Over time, these functional holding patterns can cause symptoms such as stiffness, discomfort, and joint noise from decreased joint space causing arthritis. From a more integrated perspective, the organs of the body and their function can become compromised simply from not having their natural, inherent space and blood flow.
Therefore, finding a “neutral” position of the COG, a neutral holding pattern, that focuses on the functional holding pattern is very important in changing your posture and movement. Neutral in this sense means the optimal alignment that is available for you taking into consideration the structural influences and holding patterns mentioned. It is a position that creates the least amount of stress and the most support for the body’s structure against gravity and GRF. A neutral, balanced, functional holding pattern that doesn’t compromise the spine and makes room for the internal organs while providing a strong support for the shoulder girdles and arms. In addition, a functional holding pattern that brings maximum room for the function of the hips and smooth movement of the knees, ankles, and feet. Neutral that has a range, within the length and depth and width of the skeletal structure’s base of support. A cooperative way for the body to interact with its environment and the natural forces of the earth.
Most of us become used to experiencing stability against gravity and GRF in a certain, ingrained way that becomes our postural and movement habits and behaviors. It could be referred to as our own functional holding pattern of where “I am” in space. Unfortunately overtime, these functional holding patterns, this period of equilibrium can become dysfunctional resulting in diminished volume, mobility, and health of the body’s soft tissues. Fortunately, we have the potential and capability to work with these vertical forces of gravity and GRF in new ways because of the inherent “neuroplasticity” of the brain and nervous system allowing for the old patterns to fall away.
Learning to give into gravity naturally allows for the down-weighting of the body into pronation so the structure can receive a gentle compression and folding of the soft tissues around the bones. The resulting GRF and supination then gives the body’s structure a natural lengthening to increase the joint space and stretch of the soft tissue in rehydrating and flushing the whole system. The continuous cycle of loading and unloading of our skeletal structure against the earth’s natural and vertical forces, is what creates optimal function and performance of our bodies no matter the activity.
The human brain and nervous system as already mentioned has an innate wisdom responding quickly to sensory input. It also has the potential and the capability to change for the better more easily than you think. Your body is simply shaped by the way you use it and in its response, your body shapes the way you move throughout your life. Once given useful information, your body wisdom recognizes what is better and will change the old neuromyofascial functional holding and movement patterns. That is the my goal for you in treatment at this facility. “Changing old, dysfunctional neuromyofascial, functional holding and movement patterns.” In my next article I will discuss how I read and change these dysfunctional neuromyofascia, functional holding and movement patterns in more depth. Until then, be well!
Terry